Consular Electronic Application Center - Print Application

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Online Immigrant Visa and Alien Registration Application (DS-260) Application - Sensitive But Unclassified(SBU)

Case Number:

Confirmation Number:

Personal, Address and Phone Information Name Provided:

QURESHI , FARHAN

Full Name in Native Language:

DOES NOT APPLY/TECHNOLOGY NOT AVAILABLE

Other Names Used:

NO

Sex:

MALE

Current Marital Status:

SINGLE

Date of Birth:

17 MAY 1985

City of Birth:

KARACHI

State/Province of Birth:

SINDH

Country/Region of Birth:

PAKISTAN

Country/Region of Origin (Nationality):

PAKISTAN

Document Type:

PASSPORT

Document ID:

AR4913912

Country/Authority that Issued Document:

PAKISTAN

Issuance Date:

09 MARCH 2011

Expiration Date:

07 MARCH 2016

Do you hold or have you held any nationality other than the one you have indicated above?

NO

Present Address:

611 AFSHAN APT, NUZRAT,GARDEN

City:

KARACHI

State/Province:

SINDH

Postal Zone/ZIP Code:

DOES NOT APPLY

Country/Region:

PAKISTAN

From Date:

JANUARY 1994

Have you lived anywhere other than this address since the age of sixteen?

NO

Primary Phone Number:

922132228358

Secondary Phone Number:

DOES NOT APPLY

Work Phone Number:

DOES NOT APPLY

Email Address:

[email protected]

Is your Mailing Address the same as your Present Address?

YES

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Do you have an address in the United States where you intend to live? YES Name of person currently living at address:

LATIFAN BEGUM

U.S. Address:

3100 W BELLFORT AVE #422 HOUSTON, TEXAS 77099

Phone Number:

(713)955-6093

Is this address where you want your Permanent Residence Card (Green Card) mailed?

YES

Family Information Father's Surnames:

QURESSHI

Father's Given Names:

MUHAMMAD IBRAHIM

Date of Birth:

12 JANUARY 1940

City of Birth:

JAPUR

State/Province of Birth:

DO NOT KNOW

Country/Region of Birth:

INDIA

Is your father still living?

YES

Current Address:

13100 BELLFORT #422

City:

HOUSTON

State/Province:

TX

Postal Zone/ZIP Code:

77099

Country/Region:

UNITED STATES OF AMERICA

Mother's Surnames:

BEGUM

Mother's Given Names:

LATIFAN

Date of Birth:

10 MAY 1948

City of Birth:

KARACHI

State/Province of Birth:

SINDH

Country/Region of Birth:

PAKISTAN

Is your mother still living?

YES

Is your mother's address the same as your father's?

YES

Do you have any Previous Spouses?

NO

Do you have any children?

NO

Previous U.S. Travel Information Have you ever been in the U.S.?

NO

Have you ever been issued a U.S. Visa?

NO

Have you ever been refused a U.S. Visa, been refused admission to the United States, or withdrawn your application for admission at the port of entry?

NO

Work/Education/Training Information Primary Occupation:

COMPUTER SCIENCE

Present Employer or School Name:

FARHAN INTERNATIONAL

Address:

4TH FLOOR BISMILLAH CENTREE

City:

KARACHI

State/Province:

SINDH

Postal Zone/ZIP Code:

DOES NOT APPLY

Country/Region:

PAKISTAN

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Do you have other occupations?

NO

In which occupation do you intend to work in the U.S.?

COMPUTER SCIENCE

Were you previously employed?

NO

Have you attended any educational institutions?

YES

Number of Educational Institutions Attended:

3

Name of Institution (1):

GOVT COMMERCE COLLEGE

Address of Institution:

SHARPAOO GARDEN

City:

KARACHI

State/Province:

SINDH

Postal Zone/ZIP Code:

DOES NOT APPLY

Country/Region:

PAKISTAN

Course of Study:

BUSINESS COMMERCE

Degree or Diploma:

B.COM

Date of Attendance From:

01 JUNE 2002

Date of Attendance To:

01 MARCH 2008

Name of Institution (2):

GOVT COMMERCE COLLEGE

Address of Institution:

SHARPAOO GARDEN

City:

KARACHI

State/Province:

SINDH

Postal Zone/ZIP Code:

DOES NOT APPLY

Country/Region:

PAKISTAN

Course of Study:

COMMERCE

Degree or Diploma:

INTERMEDIATE

Date of Attendance From:

01 JUNE 1999

Date of Attendance To:

01 JUNE 2002

Name of Institution (3):

NASRA SCHOOL

Address of Institution:

51 DEPOT LINE DOLIKHATA

City:

KARACHI

State/Province:

SINDH

Postal Zone/ZIP Code:

DOES NOT APPLY

Country/Region:

PAKISTAN

Course of Study:

COMMERCE

Degree or Diploma:

MARTRICULATION

Date of Attendance From:

01 MARCH 1997

Date of Attendance To:

01 JUNE 1999

Have you ever served in the military?

NO

Have you belonged to, contributed to, or worked for any professional, social, or charitable organization?

NO

Do you have any specialized skills or training, including firearms, explosives, nuclear, biological, or chemical experience?

NO

Have you ever served in, been a member of, or been involved with a paramilitary unit, vigilante unit, rebel group, guerrilla group, or insurgent organization?

NO

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Can you speak and/or read languages other than your native language?

YES

List the languages that you speak and/or read:

ENGLISH

Petitioner Information Petitioner is my:

MOTHER

Petitioner Name:

BEGUM , LATIFAN

Petitioner Address:

13100 BELLFORT #422

City:

HOUSTON

State/Province:

TX

Postal Zone/ZIP Code:

77099

Country/Region:

UNITED STATES OF AMERICA

Telephone:

(713)955-6093

Mobile/Cell Telephone:

DOES NOT APPLY

Email Address:

[email protected]

Security and Background Information Do you have a communicable disease of public health significance such as tuberculosis (TB)?

NO

Do you have documentation to establish that you have received vaccinations in accordance with U.S. law?

YES

Explain: Do you have a mental or physical disorder that poses or is likely to pose a threat to the safety or welfare of yourself or others?

NO

Are you or have you ever been a drug abuser or addict?

NO

Have you ever been arrested or convicted for any offense or crime, even though subject of a pardon, amnesty, or other similar action?

NO

Have you ever violated, or engaged in a conspiracy to violate, any law relating to controlled substances?

NO

Are you the spouse, son, or daughter of an individual who has violated any controlled substance trafficking law, and have knowingly benefited from the trafficking activities in the past five years?

NO

Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you NO been engaged in prostitution or procuring prostitutes within the past 10 years? Have you ever been involved in, or do you seek to engage in, money laundering?

NO

Have you ever committed or conspired to commit a human trafficking offense in the United States or outside the United States?

NO

Have you ever knowingly aided, abetted, assisted, or colluded with an individual who has been identified by the President of the United States as a person who plays a significant role in a severe form of trafficking in persons?

NO

Are you the spouse, son, or daughter of an individual who has committed or conspired to commit a human NO trafficking offense in the United States or outside the United States and have you within the last five years, knowingly benefited from the trafficking activities? Do you seek to engage in espionage, sabotage, export control violations, or any other illegal activity while NO in the United States? Do you seek to engage in terrorist activities while in the United States or have you ever engaged in terrorist activities?

NO

Have you ever or do you intend to provide financial assistance or other support to terrorists or terrorist organizations?

NO

Are you a member or representative of a terrorist organization?

NO

Have you ever ordered, incited, committed, assisted, or otherwise participated in genocide?

NO

Have you ever committed, ordered, incited, assisted, or otherwise participated in torture?

NO

Have you committed, ordered, incited, assisted, or otherwise participated in extrajudicial killings, political killings, or other acts of violence?

NO

Have you ever engaged in the recruitment of or the use of child soldiers?

NO

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Have you, while serving as a government official, been responsible for or directly carried out, at any time, NO particularly severe violations of religious freedom? Are you a member of or affiliated with the Communist or other totalitarian party?

NO

Have you ever directly or indirectly assisted or supported any of the groups in Columbia known as the Revolutionary Armed Forces of Columbia (FARC), National Liberation Army (ELN), or United Self-Defense Forces of Columbia (AUC)?

NO

Have you ever, through abuse of governmental or political position converted for personal gain, confiscated or expropriated property in a foreign nation to which a United States national had claim of ownership?

NO

Are you the spouse, minor child, or agent of an individual who has through abuse of governmental or political position converted for personal gain, confiscated or expropriated property in a foreign nation to which a United States national had claim of ownership?

NO

Have you ever been directly involved in the establishment or enforcement of population controls forcing a woman to undergo an abortion against her free choice or a man or a woman to undergo sterilization against his or her free choice?

NO

Have you ever disclosed or trafficked in confidential U.S. business information obtained in connection with NO U.S. participation in the Chemical Weapons Convention? Are you the spouse, minor child, or agent of an individual who has disclosed or trafficked in confidential U.S. business information obtained in connection with U.S. participation in the Chemical Weapons Convention?

NO

Have you ever sought to obtain or assist others to obtain a visa, entry into the United States, or any other NO United States immigration benefit by fraud or willful misrepresentation or other unlawful means? Have you ever withheld custody of a U.S. citizen child outside the United States from a person granted legal custody by a U.S. court?

NO

Have you ever intentionally assisted another person in withholding custody of a U.S. citizen child outside the United States from a person granted legal custody by a U.S. court?

NO

Have you voted in the United States in violation of any law or regulation?

NO

Have you ever renounced United States citizenship for the purpose of avoiding taxation?

NO

Have you attended a public elementary school or a public secondary school on student (F) status after November 40, 1996 without reimbursing the school?

NO

Do you seek to enter the United States for the purpose of performing skilled or unskilled labor but have not yet been certified by the Secretary of Labor?

NO

Are you a graduate of a foreign medical school seeking to perform medical services in the United States but have not yet passed the National Board of Medical Examiners examination or its equivalent?

NO

Are you a health care worker seeking to perform such work in the United States but have not yet received NO certification from the Commission on Graduates of Foreign Nursing Schools or from an equivalent approved independent credentialing organization? Are you permanently ineligible for U.S. citizenship?

NO

Have you ever departed the United States in order to evade military service during a time of war?

NO

Are you coming to the U.S. to practice polygamy?

NO

Are you a former exchange visitor (J) who has not yet fulfilled the two-year foreign residence requirement?

NO

Has the Secretary of Homeland Security of the United States ever determined that you knowingly made a frivolous application for asylum?

NO

Are you likely to become a public charge after you are admitted to the United States?

NO

Social Security Number Information Have you ever applied for a Social Security number?

NO

Do you want the Social Security Administration to issue a Social Security number and a card?

YES

Do you authorize disclosure of information from this form to the Department of Homeland Security, the Social Security Administration, and such other U.S. Government agencies as may be required for the purposes of assigning you a social security number (SSN) and issuing you a Social Security card and do you authorize the Social Security Administration to share your SSN with the Department of Homeland Security?

YES

Preparer of Application:

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Consular Electronic Application Center - Print Application

Did anyone assist you in filling out this application?

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NO

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